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Some diabetics prone to unsafe driving choices

NEW YORK (Reuters Health) - Drivers with diabetes who have trouble telling when their blood sugar is low may get behind the wheel when they shouldn't, a small study suggests.

The study, of 65 adults with type 1 or type 2 diabetes, found that many of those with impaired awareness of hypoglycemia symptoms thought they were OK to drive even when their blood sugar was dangerously low.

Hypoglycemia, or low blood sugar, hinders a person's ability to think and make quick judgments -- which makes driving a hazard.

In the new study, published in the journal of Diabetes Care, 21 of 45 adults with type 1 diabetes had problems recognizing they had low blood sugar. Of these patients, 43 percent felt they were able to drive even when their sugar was low.

The problem is not that these individuals did not know hypoglycemia symptoms -- such as heart palpitations, sweating, tremors and visual disturbances, explained lead researcher Dr. Alexander D. M. Stork of the University Medical Center Utrecht in the Netherlands.

Instead, their bodies don't trigger clear symptoms until their sugar levels are markedly low. This is in part because of the body's adaptation to hypoglycemia, Stork told Reuters Health, and partly due to diabetic nerve damage.

For the study, participants completed two sessions in a driving simulator, once with normal blood sugar levels and once with low sugar. During the tests they were asked whether they felt hypoglycemic and whether, in everyday life, they would drive.

Participants also rated their symptoms on questionnaires to gauge their awareness of their hypoglycemia.

Of type 1 diabetics with good awareness, just one felt OK to drive when hypoglycemic -- versus nine of 21 with poor awareness.

The bottom line, Stork said, is that people with diabetes need "early, clear and consistent education" about hypoglycemia and driving. He also stressed, though, that most type 1 diabetics with good hypoglycemia awareness made safe driving decisions.

SOURCE: Diabetes Care, November 2007.

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Article publication date: 20 Pluviôse Ray80 (21 Nov 2007)

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